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Y2S1 ANATOMY > Anatomy of the upper respiratory system > Flashcards

Anatomy of the upper respiratory system Flashcards

1
Q

Describe the organs of the respiratory system

A
  • Ethmoid bone

1) Nasal cavity

  • Palate

2) Oral cavity

3) Pharynx

  • Nasopharynx
  • Oropharynx
  • Laryngeopharynx

4) Larynx (continues as esophagus)

5) Trachea

6) Bronchi

7) Lungs

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2
Q

Describe the structure of the nose

A

1) Dorsum of the nose

  • Extends from the root to the apex

2) Nostrils

  • Nares/Anterior nasal aperture
  • They are bounded laterally by the alae cartilage of the nose

3) The bridge of the nose is bony and immovable, the movable part is the hyaline cartilage in the apex of the nose, which is partial protection

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3
Q

What is the function of the hyaline cartilage of the nose?

A

It serves as a partial protection against injury

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4
Q

Describe the structure of the nasal cavity

A

1) The roof:

  • Narrow, highest in the central region formed by the cribriform plate (where the shortest cranial nerve is the “olfactory nerve” of the ethmoid bone)

2) The floor

  • Formed by the upper surface of the palate (anterior is hard palate, posterior is soft palate)
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5
Q

What is the nasal septum

A
  • It divides the nasal cavity into right and left
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6
Q

What forms the nasal septum?

A

1) Anteriorly:

  • Septal nasal cartilage

2) Posteriorly:

  • Superiorly by the perpendicular plate of the ethmoid bone, inferiorly by the vomer of the ethmoid bone
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7
Q

What is meant by the nasal septum deviation?

A
  • It is when the nasal septum is deviated from the midline (which is usually always)
  • Can be due to trauma or congenital
  • When it is severe, the deviation can be in contact with the lateral walls obstructing breathing, exacerbating snoring, and causing more infections
  • Can be corrected by surgery if recurrent infection is there
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8
Q

Describe the structure of the lateral wall of the nose

A

1) There are three nasal conchae (turbinate bone), projecting as shelves from the lateral wall, superior, middle, and inferior conchae, the conchae create turbulence to slow down the incoming air, filtering it, between each conchae there is a meatus where the paranasal sinuses open

  • The superior and middle are parts of the ethmoid bone
  • The inferior conchae are separate

2) They increase the respiratory surface of the nose

3) The sphene-ethmoidal recess is a slit between the sphenoid bone (in the posterior part of the nasal cavity)

4) The nasolacrimal ducts and most of the paranasal sinuses open into the lateral wall of the nasal cavity

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9
Q

What is the paranasal sinuses?

A
  • They are air-filled spaces
  • They are named according to the bone where they are located

1) Frontal
2) Ethmoidal
3) Maxillary

  • They are lined by mucous membranes and secrete mucus which is drained through the nose, any infection or obstruction causes the sinuses to fill with secretion = sinusitis
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10
Q

Into which meatus do the paranasal sinuses open into?

A
  • All paranasal sinuses open into the middle meatus except:

1) Sphenoidal sinus opens into the sphene-ethmoidal recess

2) The posterior ethmoidal sinus will open into the superior meatus

3) The nasolacrimal duct opens into the inferior meatus

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11
Q

What is the lining of the nose?

A
  • The vestibule is lined with skin
  • Mucosa lines the entire nasal cavity
  • The lower 2/3 of the nasal mucosa is called the respiratory area
  • Upper 1/3 is called the olfactory area
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12
Q

What is the palate?

A
  • It is a partition between the nasal and oral cavity
  • Formed of hard anterior and soft posterior palate, which hangs off the hard palate
  • An uvula is the conical process that hangs from the free margin of the soft palate
  • During swallowing the soft palate moves posteriorly against the wall of the pharynx, preventing the regurgitation of food into the nasal cavity, which is innervated by the vagus nerve (its palsy will lead to food regurgitation)
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13
Q

What is the tongue?

A
  • It is a muscular organ, that is situated in the flow of the mouth, part of it is in the mouth and the other is on the pharynx which is separated by a V-shaped sulcus terminalis
  • It is associated with taste, speech, mastication and deglutination
  • The anterior 2/3 is movable while the posterior 1/3 isn’t
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14
Q

What are the muscles of the tongue?

A
  • The intrinsic muscles are responsible for changing the shape of the tongue
  • The extrinsic muscles are responsible for its movement

1) GENIOGLOSSUS

  • Attaches the tongue to the mandible
  • Protrudes the tongue

2) STYLOGLOSSUS

  • Attaches the lateral part of the tongue to the styloid process
  • Draws the tongue superiorly & posteriorly

3) HYOGLOSSUS

  • Attaches the lateral part of the tongue to the hyoid bone
  • Depresses the tongue

4) PALATOGLOSSUS

  • Attaches the tongue to the soft palate
  • Elevates the tongue

THEY ARE ALL SUPPLIED BY THE HYPOGLOSSAL NERVE except the palatoglossus muscle

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15
Q

What happens if the genioglossus muscle relaxes?

A

It will lead to obstructive sleep apnea

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16
Q

What can be done to prevent death from the relaxation of the genioglossus muscle?

A
  • It occurs in anesthesia and a tube is inserted to prevent it
  • In unconscious patients, the neck is extended and the chin lifted moving the tongue forward and opening the airway
  • Surgery, where you advance the origin of the genioglossus muscle by inserting it below the front teeth of the mandible
17
Q

Describe the anatomy of the pharynx

A

It is a musculofascial half-cylinder which links the oral and nasal cavities to the larynx and esophagus

1) Behind the nasal cavity is the nasopharynx where you can see the:

  • Pharyngeal tonsils, if enlarged it will lead to adenoid and adenoid face
  • opening of the auditory tube which connects the nasopharynx to the cavity of the middle ear

2) Behind the oral cavity you can see the oropharynx where you can find the:

  • Tonsils

3) Laryngeopharynx, behind the larynx

  • It directs food and water into the esophagus while air into the larynx
18
Q

What is the extension of the pharynx?

A

From the base of the skull till C6 where the esophagus and trachea start

  • The walls of the pharynx are attached anteriorly to the margins of the nasal, oral, and laryngeal cavities, which divides it into naso, oro, & laryngopharynx
19
Q

How can we view the pharynx?

A
  • THE Nasopharynx and laryngopharynx can be seen using an angled mirror
  • The oropharynx can be seen through an open mouth
20
Q

Describe the anatomy of the nasopharynx

A
  • The part of the pharynx that lies behind the nasal cavity
  • It has a respiratory function and stabilization of the pressure in the ear
  • Always kept patent by the pharyngobasilar fascia
  • It has an opening for the auditory (eustachian) tube which lies in the lateral wall, equalizing the pressure of the middle ear with the atmospheric pressure
  • It contains the nasopharyngeal tonsils, which if enlarged can obstruct the nasal breathing “adenoids”, patients present with an adenoid face “هدول اسمهم اللحمية”
21
Q

Describe the anatomy of the oropharynx

A
  • The part of the pharynx which lies behind the oral cavity “tongue”
  • It has a digestive and respiratory functions
  • Closes during swallowing only
  • Laterally it has two ridges on each side (palatoglossal “between the palate and the tongue” and palatopharyngeal “between the palate and the anterior wall of the pharynx” folds) where the palatine tonsils lie in between in the tonsilar fossa
  • In children, the palatine tonsils are larger, and they enlarge in tonsillitis and peritonsillar abscess causing airway obstruction
22
Q

Describe the anatomy of the laryngopharynx (hypopharynx)

A
  • Lies behind the larynx
  • Clinically named as hypopharynx
  • It communicates with the larynx anteriorly through the inlet of the larynx
  • It has the piriform fossa, where foreign bodies that are tucked in the trachea might be lodged due to the cough reflex, as it is found lateral to the laryngeal inlet
  • The internal laryngeal nerve is found in the floor of the piriform fossa which might be injured if an instrument was inserted to remove a foreign body
23
Q

Where is the larynx located?

A
  • It lies in the anterior midline of the neck, in front of the 3rd, 4th, 5th & 6th cervical vertebrae
  • At C6 both the trachea and esophagus starts
24
Q

What forms the larynx?

A
  • External skeleton/frame of cartilage
  • Internal vocal cords and muscles
25
Q

What is the function of the larynx?

A
  • Vibrates to produce sound for speech
  • Channels air out of the trachea
26
Q

Describe the anatomy of the larynx

A
  • Single, unpaired cartilage:

1) Thyroid cartilage

  • Forms Adam’s apple
  • It has a posterior opening
  • Has the epiglottis at the anterior

2) Cricoid

  • The only complete cartilage in the respiratory system
  • It is a complete ring over the trachea, under the thyroid
  • Found at C6
  • Contains two pyramid shape cartilage “arytenoids”
  • Paired cartilage

1) Arytenoid

2) Corniculate (seen within the aryepiglottic folds)

3) Cuneiform (seen within the aryepiglottic folds)

27
Q

What is the laryngeal inlet, and what are its boundaries?

A
  • It is an oblique opening into the laryngopharynx

It is bounded by:

1) Anteriorly: The epiglottis

2) Posteriorly: Interarytenoid fold of the mucous membrane

3) On each side: Aryepiglottic fold

27
Q

Which structure form a complete cartilage?

A

Cricoid cartilage

28
Q

What are the laryngeal membranes?

A

1) Thyroid membrane:

  • Extends from the upper border of the thyroid cartilage to the upper part of the posterior surface of the hyoid bone
  • Its median part is thickened forming the median thyrohyoid ligament
  • Its posterior border is thickened forming the lateral thyrohyoid ligament

2) Cricothyroid membrane (conus elasticus)

  • It is triangular in shape, and its base is attached to the arch of the cricoid
  • Its apex is attached to the medial surface of the thyroid cartilage
  • Its upper free border forms the vocal ligament
  • It anterior is thick known as the cricothyroid ligament (the site of an emergency tracheotomy)

3) Quadrate membrane

3) Cricotracheal membrane

29
Q

Describe the structure of the quadrate membrane

A
  • Free at the top and bottom
  • Attached posteriorly to the arytenoid cartilage, and anteriorly to the side of the epiglottis
  • The lower free margin forms the false vocal cords (vestibular ligament)
  • The upper free border forms the aryepiglottic ligament which encloses the uniform and the corniculate cartilage
30
Q

What connects the anterior surface of the epiglottis with the hyoid bone?

A

The hypo-epiglottic ligament

31
Q

What connects the lower end of the epiglottis to the back of the thyroid cartilage?

A

The thyro-epiglottic ligament

32
Q

Describe the structure of the cricotracheal membrane

A

It connects the lower end of the cricoid cartilage with the 1st cartilage ring

33
Q

Describe the laryngeal cavity

A

1) The inlet which lets the air into the trachea, then to the vestibular space

2) The vestibule: a fold above the ventricular groove in the trachea, superior to the vestibular fold

3) The ventricle: between the vestibular fold above it and the vocal fold beneath it

4) The infraglottic space is below the vocal folds and leads to the trachea

34
Q

How to perform the Heimlich maneuver?

A
  • Chocking on food is a common cause of laryngeal obstruction

To perform the Heimlich maneuver:

1) Cover your fist with your other hand and thrust up lifting the victim on his feet, creating pressure in the abdomen under the thorax

2) The diaphragm will then move superiorly, forcing the air out of the lungs and expelling any foreign bodies

  • In infants you place their stomach across your forearm, giving five thumps on the back with the heel of your hand
35
Q

How to perform cricothyrotomy?

A
  • Used in emergency
  • Using a knife to cut through the cricothyroid ligament
  • A small tube is inserted
  • Positive pressure ventilation then might be adminestered

Y2S1 ANATOMY (15 decks)

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